Immunocompromised children and young people are at no increased risk of severe COVID-19

H Chappell; R Patel; C Driessens; A W Tarr; W L Irving; P J Tighe; H J Jackson; T Harvey-Cowlishaw; L Mills; M Shaunak; D Gbesemete; A Leahy; J S Lucas; S N Faust; H de Graaf

doi:10.1016/j.jinf.2021.11.005

Immunocompromised children and young people are at no increased risk of severe COVID-19

J Infect. 2022 Jan;84(1):31-39. doi: 10.1016/j.jinf.2021.11.005. Epub 2021 Nov 14.

Authors

H Chappell¹, R Patel², C Driessens³, A W Tarr⁴, W L Irving⁴, P J Tighe⁵, H J Jackson⁶, T Harvey-Cowlishaw⁶, L Mills¹, M Shaunak¹, D Gbesemete⁷, A Leahy⁸, J S Lucas⁹, S N Faust⁹, H de Graaf¹⁰

Affiliations

¹ NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK.
² Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK.
³ NIHR Applied Research Collaboration Wessex, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK.
⁴ NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK; School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK; Wolfson Centre for Global Virus Research.
⁵ NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK; School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK.
⁶ School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK.
⁷ NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK.
⁸ Paediatric Medicine, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK.
⁹ NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK; Paediatric Medicine, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK.
¹⁰ NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK; Paediatric Medicine, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK. Electronic address: [email protected].

Abstract

Objectives: We aimed to prospectively describe the incidence and clinical spectrum of SARS-CoV-2 infection in immunocompromised paediatric patients in the UK.

Methods: From March 2020 to 2021 weekly questionnaires were sent to immunocompromised paediatric patients or their parents. Information, including symptom presentation and SARS-CoV-2 PCR test results, was collected from 1527 participants from 46 hospitals. Cross-sectional serology was investigated in February and March 2021.

Results: Until the end of September 2020, no cases were reported. From September 28th 2020 to March 2021 a total of 38 PCR-detected SARS-CoV-2 infections were reported. Of these, four children were admitted to hospital but none had acute severe COVID-19. Increasing age in association with immunodeficiency increased reporting of SARS-CoV-2 infection. Worsening of fever, cough, and sore throat were associated with participants reporting SARS-CoV-2 infection. Serology data included 452 unvaccinated participants. In those reporting prior positive SARS-CoV-2 PCR, there were detectable antibodies in 9 of 18 (50%). In those with no prior report of infection, antibodies were detected in 32 of 434 (7•4%).

Conclusions: This study shows SARS-CoV-2 infections have occurred in immunocompromised children and young people with no increased risk of severe disease. No children died.

Keywords: COVID-19; Children; Immunocompromised; SARS-CoV-2.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
COVID-19*
Child
Cross-Sectional Studies
Hospitalization
Humans
Immunocompromised Host
SARS-CoV-2